A person who made the sun glow brighter- Acharya Sushruta

Blog # 3 in series of # 10 reasons
why Acharya Sushruta is called the Father of surgery?

Let's take a look at a scenario that happened about 2000 years ago. Generally, the eyesight of senior citizens starts getting blurred after the age of 60 years. This person gradually became unable to do his work, he had to rely on other people even for simple routine tasks. The main reason behind all these conditions is cataract which is mentioned by Sushrutacharya as Linganash / Nilika / Kach.

A gradual but increasing day-to-day visual impairment results in partial or complete blindness in a physically fit person. From the point of view of the earlier society, such a person was like a parasitic burden. A cataract is one of the natural changes that take place in the body with age. Even today, cataract patients are treated exclusively by surgery. Scientists are working to find a solution in the form of a perfect, preventive, prescriptive drug. At this early age time, Sushrutacharya had acquired the skill of successfully performing surgery by studying the disease which causes such impairment. Let's take a look at how cataracts occur, what treatments are given for them, and what is the contribution of Sushruta in them.

What is a Cataract?

    The light reaching the eyes [as shown in the picture below] is reflected through the lens of the eye and its shadow falls on the retina. This signal then travels through the retina, optic nerve, optic chiasma to the brain step by step and then we see the object.

Due to the natural changes that take place in the body with increasing age, the previously transparent lens becomes first partially & gradually completely translucent or opaque. As a result, the image on the retina becomes blurred.

And as the lens changes from partially translucent to complete opaque, vision deteriorates. If left unmanaged, they can make people partially or completely blind, dependent & handicapped.

Description of Cataract according to Sushruta Samhita-

रुणाद्धि सर्वतो दृष्टिं लिंगनाशः स उच्यते | 

तस्मिन्नपि तमोभूते नातिरूढे महागदे||

- Su. U. 7/16

When the defects in the body become visible and blocked, even objects with intense light like sun, moon, lightning appear dim [i.e. it is very difficult to see normal objects, vision becomes dull].

To perform the surgery properly and successfully, it is as important to thoroughly examine a patient before posting for surgery, needs to perform surgery properly, all the activities of post-operative patient care till the wound heals need to be delivered with optimum care. Recognizing this essence, Sushruta divides this surgery into three stages, namely, Poorva-karma [pre-preparation], Pradhan-karma [Main operation], and Pashchat-karma [all actions of caring for the patient until the wound is completely healed].

Poorvakarma [pre-preparation]

- The patient should be examined properly

- Proper diagnosis of defects and disorders

- Is surgery necessary in the treatment of diseases?

This should be confirmed. This is because if the wrong person is operated on without considering all of these things, it may harm the patient by the incidence of increased bleeding or vision will get impaired. [Su.U. 17 / 71,72]

- According to Ayurveda, any ailment is caused by the altered quality & quantity of Vata, Pitta, and Kapha dosha. Sushruta advises performing Sharir shuddhi kriya to pacify aggravated Tridosha. After this, the patient should be asked to get ready for the surgery.

Pradhan Karma [Main operation]

- Patient status - This patient should be kept on fasting on the day of surgery.

- Equipment - All the surgical equipment & instruments should be kept ready on the right day.

- Facing the patient to the east, the patient is asked to lie on their back with their neck slightly raised. The patient assistant should hold the head in such a way that the head does not move during the procedure.

Basic Principal of The Main Surgery

- Eye should be pierced at a specific site, taking care to keep the grip firm & not to shake the hand. The weapon pierced in the eye should be rotated in such a way that the part of the opaque eye lens separates from its original position. This action removes the translucent fault of the eye lens which obstructs light from reaching the eye. This action restores the patient's vision as the light reaches the inside of the eye uninterrupted. The patient begins to see all things & the sun's glare appears to be even brighter than before.

The main purpose of cataract surgery, which is still performed today, is to remove or clean the opaque eye lens. References - Cataract surgery- Wikipedia: - During cataract surgery, a patient's cloudy natural cataract lens is removed, either by emulsification in place or by cutting it out.

- After proper removal of the defect, the wound should be treated with appropriate drugs.

Pashchat-karma [Post-surgery care of the patient till the wound heals completely]

- The patient should be told to rest in a supine position, protecting in dust or wind-proof place. After 3 days, dressing& wound care should be done.

- The patient's diet should be gradually increased and appropriate medications should be given for wound healing.

- Patient was instructed to avoid forceful coughing, sneezing, spitting, lying on your stomach, looking at a bright light or micro-objects until the eye lesion is completely healed.

- If the wound does not heal properly during the next dressing or if there is any undesirable effect [complication]after surgery, then it should be evaluated keenly & treated appropriately. Sushrutacharya describes the reasoning behind complications which could be performing surgery on an improper patient, the use of an improper instrument, the improper handling of an instrument, or the patient's lack of proper care and the appropriate remedies. [Su.U. 17/79]

Similarities of Sushruta Shalyakarma to Eye surgery in Modern times

- Pre-operative evaluation to check and confirm whether the patient is fit for surgery,

- Not to operate on other eye lesions other than cataracts

- To carry out everything with proper caution and a stepwise approach

- Anesthesia however not mentioned in verses, it is assumed that anesthesia is performed before all surgeries]

- Position of patient

- Patient fasting [Nil by mouth- NBM] on the day of surgery

- Eye piercing [incision], surgery [Couching procedure], post-operative wound care & dressing.

- Medicine and care for ulcer healing

These steps are common between those written by Acharya Sushruta & that of modern Surgical Skills in the same sequence.

Most of the above procedures were the same till 1965. The use of the Couching procedure in the above description has been declining since the new easy-to-use method with fewer side effects Phacoemulsification method was developed in 1966. But even today, in some parts of economically backward regions of Africa, the Couching method of eye surgery described by Sushruta is still practiced.

From all these descriptions we can say with certainty that Sushrutacharya had detailed knowledge of the step-by-step approach and extraordinary surgical skill in the pre-Christian era and had successfully treated patients. That is why he is called the Father of Surgery. And this is how Sushrutacharya makes Ayurveda OMG Amazing Ayurveda…!

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Information about the author

Dr. Ninad Nayan Sadvilkar, M.D. [Ayurveda]

[Strong supporter, believer, motivator, teacher & practitioner of Ayurveda]

Assistant professor, MES Ayurved Mahavidyalaya, Lote, Tal.-Khed, Dist.- Ratnagiri, Maharashtra & 
Owner, Aarogyavardhan Ayurved & panchakarma Treatment Centre, Shop number-1, Sagar plaza, Chiplun

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